One of world's most respected medical journals, the Lancet, recently called for regime change in a once-great country whose health policies are succumbing to "the politics of fear and neglect" and "profound intolerance". Its target? Zimbabwe? Pakistan? Kazakhstan? No, the Lancet was referring to Australia. In a biting editorial, the journal called upon voters to let shine "a new enlightenment to Australian health and medical science".
Earlier this month its editor, Richard Horton, visited Sydney. He must have briefed himself on the state of Australian science. The editorial, for instance, quotes "the respected scientist Ian Lowe" on the "extraordinary lengths" that the government had taken to "silence independent opinion within the research community". Professor Lowe is a respected scientist, but the Lancet's readers also deserved to know that he had been speaking as president of the left-leaning Australian Conservation Foundation.
I don't regard myself as a supporter of the conservative incumbent government, but I am alarmed at this heady mix of politics and medical science. The Opposition's spokeswoman on health, Nicola Roxon, was a bit hasty in describing the editorial as "a devastating indictment of the Howard Government's record". Words like these could create an expectation that within a few months after an election victory, enlightened researchers from her side of politics will cure the obesity epidemic, the asthma epidemic and the depression epidemic, along with finding a solution to the appalling state of Aboriginal health in Australia.
Unhappily, the Lancet editorial is only the most recent example of a worrying increase in advocacy science in top flight journals. Traditionally these luuminaries have confined themselves to their areas of expertise. Public policy in areas such as HIV/AIDS or Aboriginal health was discussed in terms of specific programs, not as political huckstering. But with the election of conservative governments in both the United States and Australia, neurons in editorial cerebella started to misfire madly. Not only the Lancet, but also the UK-based British Medical Journal and Nature and the US-based New England Journal of Medicine, the Journal of the American Medical Association and Science, have become increasing hostile towards the Bush Administration.
With some reason, of course. The American health system is a mess. The Bush administration has apparently tinkered with official reports, sacked recalcitrant scientists and placed sympathetic officials in key positions. But that's exactly what voters expect politicians to do. When they read newspapers, they hold their noses and measure governments' ever-improving graphs and optimistic forecasts with a bulldust meter.
But not when they read medical and science journals. Like Nicola Roxon, they naively expect that the white-coated gods of science speak truth to power in words uncontaminated by ideological prejudice.
No longer. The journals have more or less squarely allied themselves with the liberal side in America's culture wars over abortion rights, therapeutic cloning, sex education, AIDS policies and population control. It has become nearly impossible for dissident scientists to get papers published in these sensitive areas because — so they claim — independent opinions are silenced.
The new field of stem cell research offers the clearest and most egregious example. Back in 2003, after President Bush had restricted funding for embryo research, the editor of the NEJM, Jeffrey Drazen, vowed to aggressively seek out and publish research on embryonic stem cells. "Physicians and scientists in the United States should be at the centre of the action, not on the sidelines," he argued. He dismissed ethical objections. The other journals, including The Lancet, did much the same, even though they admitted that there were "few tangible clinical benefits to report".
The consequences of this ideologically blinkered policy were not long in coming. Science rushed into print two stunning articles about the creation of the world's first human therapeutic clones and stem cell lines. It was a brilliant coup which vindicated its editorial opposition to Bush's ethical and scientific caution.
And it turned out to be the worst fraud of the past hundred years, the handiwork of a publicity-hungry South Korean researcher who knew that Western journals were equally hungry to prove their case. How the editor of Science, Donald Kennedy, responded to this humiliating turn of events is instructive. Like any beleaguered politician, he appointed his mates to an investigating commitee: three current editors at Science, one former editor at Science, and two of the most passionate advocates of embryonic stem cell science in the US. It was hard to imagine a team less likely to ask tough questions. Had editorial misgivings been steamrollered because of his partisan commitment to embryo research? We shall never know.
The real victims of a growth in political advocacy will be the journals themselves. With rising levels of fraud and self-serving commercialism in the ivory towers of academia, the credibility of leading journals is a more valuable asset than ever before. Politicking editorials can only tarnish this.
And a habit of playing politics can backfire in unexpected ways. In an entertaining example of holier-than-thou-manship, the British Medical Journal is currently campaigning to knock the Lancet's halo into a cocked hat. Out of "sisterly concern for a fellow journal", it has called for a boycott because the Lancet's publisher, Reed Elsevier, receives about one two-hundredth of its revenue from organising fairs for the international arms trade. Richard Horton's explanations have been rather feeble.
If the Lancet's friends play games like this, there is little need for the Australian government to panic over the attack on its own far-from-perfect record.
Michael Cook is editor of MercatorNet. A version of this article was published in The Australian newspaper.